Ultrasound in the diagnosis and management of fibular mononeuropathy

Introduction Ultrasound (US) evaluation of peripheral nerves is a noninvasive, cost‐effective approach to diagnosing focal mononeuropathies and guiding surgical management. We used the intranerve ratio to evaluate for possible cut‐off values in diagnosis of fibular mononeuropathies (FNs). Methods A...

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Bibliographic Details
Published in:	Muscle & nerve Vol. 60; no. 5; pp. 544 - 548
Main Authors:	Bucklan, Julie N., Morren, John A., Shook, Steven J.
Format:	Journal Article
Language:	English
Published:	Hoboken, USA John Wiley & Sons, Inc 01-11-2019 Wiley Subscription Services, Inc
Subjects:	ancillary Diagnosis Electrodiagnosis Female fibular Ganglion Cysts - complications Ganglion Cysts - diagnostic imaging Ganglion Cysts - surgery Humans Knee Lesions Limbs Male Medical diagnosis Middle Aged mononeuropathy Nerve Sheath Neoplasms - complications Nerve Sheath Neoplasms - diagnostic imaging Nerve Sheath Neoplasms - surgery Neural Conduction neuromuscular neuropathy Organ Size Peripheral nerves Peripheral nervous system Peripheral Nervous System Neoplasms - complications Peripheral Nervous System Neoplasms - diagnostic imaging Peripheral Nervous System Neoplasms - surgery Peripheral neuropathy peroneal Peroneal Nerve - diagnostic imaging Peroneal Nerve - pathology Peroneal Neuropathies - diagnostic imaging Peroneal Neuropathies - etiology Peroneal Neuropathies - surgery Retrospective Studies sonography Statistical analysis Subgroups Surgery Ultrasonic imaging Ultrasound mononeuropathy neuromuscular fibular peroneal neuropathy ancillary sonography ultrasound
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Summary:	Introduction Ultrasound (US) evaluation of peripheral nerves is a noninvasive, cost‐effective approach to diagnosing focal mononeuropathies and guiding surgical management. We used the intranerve ratio to evaluate for possible cut‐off values in diagnosis of fibular mononeuropathies (FNs). Methods A retrospective analysis of FN confirmed by electrodiagnosis (EDx) was performed to identify intranerve ratio values between affected and unaffected limbs at the fibular head and popliteal fossa. Results The optimal fibular head/popliteal fossa intranerve ratio to discriminate between limbs with and without disease was 1.25 (sensitivity, 51%; specificity, 71%). There was no statistically significant difference between affected vs unaffected limbs (ratio, 1.13; P = .15) nor in subgroup analyses. However, 25% of patients had structural lesions amenable to surgery. Discussion The utility of US in diagnosis of FN is limited using intranerve ratio data, but US has a distinct advantage over EDx for identifying treatable structural lesions.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0148-639X 1097-4598
DOI:	10.1002/mus.26652